Achilles Tendon Grabbing You?

Amongst all the exciting playoff basketball with March Madness, David Beckham will have plenty of time to watch all the action at home. He unfortunately suffered an Achilles Tendon rupture on March 14th during a match against Italian football club Chievo. Achilles tendon ruptures, although not too common, can be quite difficult to treat.

Achilles tendon tears/ruptures most frequently happen to the “weekend warrior.” They often happen to people who are a bit out of shape, and a few years removed from their heavy activity days. They go out for a random pick-up basketball or football game with friends, don’t warm up slowly and gradually, don’t stretch, and end up tearing their Achilles. They can also happen by overuse, improper footwear, certain drugs (such as steroids and an antibiotic class known as quinolones), and direct injury. People usually describe the injury as though they have been kicked in the back of the leg, hear or feel a loud pop, and feel a sharp and intense pain.

The Achilles Tendon functions as fibrous tissue that connects the heel to the muscles of the lower leg. It is a very strong tendon, but unfortunately has one downfall! There is an area known as the “watershed” region, which is where most of the tears occur. This is because it is an area of very poor blood supply, so it does not get as much nutrition from blood supply as the other areas. Depending on how bad the tear is, there are several different options for treatment.

If the tendon is only strained, then a regimen of rest, followed by strengthening and stretching can be implemented. In order to provide maximum rest, the foot and ankle can be casted or placed in some type of controlled motion boot. Not allowing the foot and ankle to move is crucial to hearling! If there is an actual tear, often times surgical intervention is necessary. They will cut out the part of tendon that is torn/damaged. At that point, with a small tear they can sometimes sew together the healthy portion of tissue, or with a larger tear they can use a graft or synthetic Achilles tendon to replace the one that was torn, and sew it in place of the tendon that was taken out.

Achilles tendon ruptures are an unfortunate injury to happen to anyone, but with proper care and treatment provided by your podiatrist, you can get back in to the game quickly!


The purpose of this blog is to raise awareness about common conditions associated with the foot and ankle. Any advice given, whether medical or legal, is an opinion. For legal counsel or podiatric care, one should see their local podiatrist or attorney. More information can be found at my website www.michiganfootdoctor.com

Running pains?

As the nice weather embarks upon us, we find ourselves venturing outside more often to enjoy the great outdoors. For those of us who are getting back in to running, or increasing the training regimine, you may notice some areas are beginning to hurt! If what begins as a fun run, turns into moans and groans, read along to see what you can do to ease your pain.

Many people often experience pain along the front of their shins when they run. These so called “shin splints” can have you doubling over in pain, and put an immediate stop to your run, and destroy your desire to do so again. Medial Tibial Stress Syndrome (shin splints) can also be caused by other activities, including jumping, dancing, and sprinting. It is often attributed that the pain comes from the muscle group that lies on the front of the leg, which acts to bring the toes up towards the sky (dorsiflex the foot). What causes this muscle group to become aggravated is forceful slamming of the heel against the ground. Through normal running motion, your anterior muscle group picks your toes up towards the sky while your foot coasts in the air so you don’t trip. As the heel hits the ground, the muscles on the front of the leg work to hold the toes up (dorsiflex), but are placed under a very forceful contraction. This causes a rapid response of the muscles to “fire back” to counteract the force. Over time (period of minutes to hours), the muscles become fatigued and irritated, and cause the pain that can span the front of the leg.

Another possible cause is over-powering of the calf muscles. Since the two muscle groups are antagonistic (work against each other), if one is markedly stronger than the other, it can make a big difference. There are also a few aggravating factors, such as over pronation of the foot (where the arch collapses), insufficient time for a warm-up, over-training, or a chronic compartment syndrome. This is when the swelling of the compartment in the leg that contains the anterior muscle group cuts off blood supply to the muscles, causing immense pain, numbness, and skin color changes.. This is a very serious condition, so if you have any concerns that you may have this, see your podiatrist immediately!

The good news is that this nagging shin splint problem is very easily treated in most instances. In most cases rest, ice and non-steroidal anti-inflammatory medication can relieve symptoms. It is definitely encouraged to make sure you are providing ample time for a warm-up, and gradually increasing training activity to allow for your body to respond to the demands placed on it. One other very helpful pain-relief tool is custom made orthotics, to ensure your foot is in a proper alignment.

With this knowledge, make sure to not let shin splints ruin your summer outdoor activities. Enjoy nature in all its glory, pain free!

The purpose of this blog is to raise awareness about common conditions associated with the foot and ankle. Any advice given, whether medical or legal, is an opinion. For legal counsel or podiatric care, one should see their local podiatrist or attorney. More information can be found at my website www.michiganfootdoctor.com

Feet on Fire?

After spending time outdoors, ever notice that your feet are “feel like they are on fire?” Did you remember to put sunscreen on all the sun exposed parts, except your feet? There are important reasons to make sure you never leave your feet unprotected from the sun again!

Feet are an often a neglected area of the body when thinking of sun exposure. The consequences of forgetting to cover your feet can be not only painful, but also dangerous! Sunburn can be especially painful on the tops of ankles, feet and toes because skin is very sensitive there. You experience similar symptoms as with any burn; pain, redness, swelling, and eventually peeling or blisters. Sun burns are caused by ultraviolet (UV) radiations resulting in skin inflammation. The symptoms can start within 30 minutes of exposure, so always be sure to put on powerful sunscreen! UVA and UVB refer to different wavelengths in the light spectrum. UVB is more damaging to the skin and is more often the cause of skin cancer. Both UVA and UVB are also responsible for premature aging of the skin, wrinkles (photoaging) and sunburn. While sunburns to the feet are painful they can have, more devastating effects on your feet.

Sunburns can cause or exacerbate long term detrimental effects, including several different types of soft tissue tumors of your feet, which can be categorized into benign or malignant. Benign tumors are ones that may need to be biopsied to confirm their status. If these need treatment they usually heal uneventfully and biopsies do not reveal any cancerous cells. These benign tumors can include: eccrine poroma, ganglionic cysts, glomus tumor, intractable plantar keratoma, mucoid cyst, pigmented villonodular syntovitis, plantar fibromatosis, and synovial cysts. Malignant tumors of the foot are ones that are cancerous, and can be very dangerous if not treated quickly and properly. The malignant tumors of the feet include: malignant melanoma, kaposi’s sarcoma, and squamous cell carcinoma.

One treatment that is frequently used for lower extremity burns is the application of aloe lotion to soothe the burn. This can be applied as frequently as you would like, and is recommended to be applied at least three times per day while the burn is still in an active or acute phase. If the skin is blistering, or you feel you may have suffered third degree burns, you should seek medical attention. You should also be aware of any signs of heat stroke or heat exhaustion, as these can be a very serious systemic illness that can affect the functioning of your body and in severe cases of sunburn may lead certain organs shutdown!

Remember, apply suntan lotion to your feet and legs whenever you expect them to be in the sun for any extended period of time.

The purpose of this blog is to raise awareness about common conditions associated with the foot and ankle. Any advice given, whether medical or legal, is an opinion. For legal counsel or podiatric care, one should see their local podiatrist or attorney. More information can be found at my website www.michiganfootdoctor.com

Are your feet flat?

Do you notice your feet are as flat as a pancake when you walk? Does it seem like the only arch you see is at your local McDonalds? The more important question is, are your flat feet painful? Many people notice that they have flat feet, but never have any pain. As our flat-footed friends age, their feet oftentimes become painful. What is the root cause of all these flat feet?

Flat feet areoften be called by another term, known as pronation. Pronation is described as when the arch collapses during weight bearing, and the inside of the ankle seems to roll towards the ground. Pronation can be from a flexible flat foot, when the arch collapses as the foot hits the ground, or a rigid or structural flat foot, which stays flat no matter what stress the foot encounters.
There are many causes of flat feet. Some include obesity, pregnancy and repeated pounding ones feet against hard surfaces. If a close relative has flat feet the odds are good that you may develop this condition! There also is a higher association of developing flat feet if you have rheumatoid arthritis. Some other causes besides a congenital abnormality (something you’re born with) are a bone fractures or dislocations, torn or stretched tendon s, or neurologic weakness.

Flat feet can present differently in children and adults. In kids, flat foot usually presents as flexible or hypermobile flat foot. This condition is rarely painful. The prudent podiatrist may recommend custom molded orthtics to support the arches as their feet grow. If the Achilles tendon (along the back of the foot/lower leg) is tight, then this foot type can become problematic. Children very rarely a have a rigid flat foot, which is usually from a coalition (bones that do not move and are fused together). Adult acquired flat foot is usually more of a progressive deformity. The tendon on the inside of your ankle, the posterior tibial tendon, that goes into the foot weakens and sometimes even tears resulting in severe pain and total collapse of the arch.

What type of symptoms will you experience? Your feet can become painful when standing for long periods, or they may tire easily, with pain in the arch or heel. Oftentimes there is a chance of swelling in these areas. You may experience difficulty with moving your feet or heels. Sometimes difficulty or pain develops when you try to stand on your toes.

What type of treatments can be done? There are several methods of conservative treatment that can be implemented. To begin with your doctor will probably start with shoe modifications and custom molded orthotics, designed specifically to your feet, and non-steroidal inflammatory medications such as ibuprofen. Corticosteroids can also be injected into painful joints, along with rest, ice decreasedactivity, short leg casts, and custom designed ankle support braces. Depending on the severity and type of flatfoot you have, your doctor may put you on a stretching regimen for to lengthen your tight Achilles Tendon/Gastrocnemius (calf muscles). If the above treatments are ineffective,a course of physical may be indicated. When conservative measures have failed surgical intervention may be necessary. Some of the surgical procedures that can be performed include an arthrodesis (fusion of the major moving joints of the feet to correct the position of the foot/arch), osteotomy (cutting, shifting and /or reshaping a bone for better alignment), and/or tendon transfer (where a tendon in the foot/ankle is transferred to another area of the foot. The podiatric surgeon may also want to lengthen your Achilles tendon/calf muscles sometimes using several very small incisions.
If your feet are flat as a board, and causing you pain, make sure to consult your podiatrist. He or she will be able to properly diagnose this condition, and other foot/ankle ailments may be causing your pain. Pain free feet are happy feet so make sure you keep your feet happy throughout the summer months!

The purpose of this blog is to raise awareness about common conditions associated with the foot and ankle. Any advice given, whether medical or legal, is an opinion. For legal counsel or podiatric care, one should see their local podiatrist or attorney. More information can be found at my website www.michiganfootdoctor.com

Dare to bare your Bunion!

With warm weather just around the corner, those feet you were hiding will soon be in sandals! Worried that all your friends will see your big bunion bumps? Do you have no idea what I am talking about so far?? Well enjoy the ride as we discuss all you need to know about the wide world of bunions!!

A bunion is when your big toe begins to move towards the rest of your smaller toes, and most likely is accompanied by a bump on the inside edge of the big toe. The problems that most people experience with bunions are red and calloused skin along the bump of the bunion, along with swelling of the big toe joint, with decreased range of motion and stiffness in the joint. The worst part of all though is some can experience PAIN during walking with any type of tight fitting shoes

Bunions can be caused by several factors. Bunions most commonly affect women, as types of shoe gear are often aggravating factors. Tight fitting shoes, especially high heels, can have a profound impact on developing buions. As the amount of hours per day, as well as number of years you spend in such ill-fitting shoes, the more likely a bunion will develop, or increase in severity. Bunions can also be genetic, or accompanied by another ailment, such as rheumatoid arthritis, or based on the type of foot you have. Pronation (a foot that rolls flat as you walk) or a splay type of foot, can also be predisposed to developing bunions.

Buions can be diagnosed through both a clinical evaluation by your podiatric physician, as well as taking an x-ray. X-rays are a very helpful tool, as your doctor will use the measurements he takes of a few different angles of the foot to determine the best option for treatment. With a very mild bunion that causes little pain or discomfort, it is advised to try and wear shoes with a wider toe box to provide more room for your feet, with the occasional Ibuprofen or aspirin for pain relief. There are also different types of spacing devices and braces that can be used to try and conservatively treat bunions, in addition to physical therapy to increase joint range of motion, as well as special custom molded inserts that allow for more room. If the bunion has been present for a long time, or is very painful or rigidly fixed, then surgery may be a good option. There are hundreds of different procedures, and variations of each procedure that can be done, all with excellent outcomes.

A similar type of foot problem is known as a tailors bunion. This has all the same type of causes, symptoms, and treatment, except the location is different. Tailors bunions occur at the other side of the foot, involving the joint of the 5th or pinky toe! Many people even opt to get both procedures done at the same time! With sandal weather quickly approaching, make sure to see your local podiatrist to address your bunions as soon as you can! You are entirely too busy and important to be living with pain!


The purpose of this blog is to raise awareness about common conditions associated with the foot and ankle. Any advice given, whether medical or legal, is an opinion. For legal counsel or podiatric care, one should see their local podiatrist or attorney. More information can be found at my website www.michiganfootdoctor.com

Ever feel any burning, tingling, or a numbness in your feet?

Do the symptoms above describe how your feet feel from time to time? Are you a diabetic? Odds are, you could have what is known as diabetic peripheral neuropathy. What exactly is that, and how did you get it?

Peripheral neuropathy is a condition that most commonly produces symptoms such as burning, numbness, tingling, pain, and loss of muscle function and reflexes in extremities. The areas most commonly affected are the feet and hands. The symptoms can eventually spread "proximally," towards the legs and arms. Causes of peripheral neuropathy besides diabetes include: renal or liver failure, hypothyroidism, excess vitamin B6, deficiency of vitamin B12 or vitamin A, Guillian-Barre Syndrome, systemic lupus erythematosis, leprosy, and shingles, to name a few.

More specifically, diabetic peripheral neuropathy, also called distal symmetric neuropathy or sensorimotor neuropathy, is unfortunately something that as many as sixty to seventy percent of the diabetic population end up experiencing. People with a history of diabetes for over 25 years, or those with uncontrolled blood sugar levels tend to experience the most severe neuropathy symptoms. Once the neuropathy symptoms develop it is very imperative to see your podiatrist on a regular basis for routine and episodic diabetic foot care and risk management.

Your podiatrist will check your feet at a minimum yearly, to assess the skin, muscles, bones, circulation, and sensation of your feet. They will assess the protective sensation in your feet by using an instrument called a Semms-Weinstein 5.07 monafilament wire to determine the extent of your condition. They may also use a tuning fork to assess vibratory sensation.

There are several treatment options for diabetic peripheral neuropathy. First and foremost is to keep blood glucose levels in the normal range, as set by your endocrinologist and podiatrist. Other options include medications both by mouth and topically that is rubbed into the skin. Physical therapy can also help decrease the pain.

It is very important to assess your feet for any type of peripheral neuropathy, especially if you're a diabetic! , The chances of foot injury or infection increases tremendously once sensation to your feet is lost. Oftentimes diabetics cannot even feel something as small as a rock rubbing in their shoes. This can lead to an ulcer (an open wound that does not heal), and possibly progress even to an amputation. The literature indicates that of the 86,000 amputations per year, more than half are in diabetics. This number can drastically be reduced if proper foot care is instituted. Diabetics need to check their feet daily for any rashes, cuts, blisters, scabs, growths, swellings, redness/discolored areas, infections, calluses and for any other suspicious looking areas. Applying the proper lotion to the feet, wearing properly fitting shoes (Medicare does cover diabetic shoes and inserts for qualifying diabetics which look like regular shoes) are also crucial to good foot health. Take good care of your feet, and they will take good care of you for many years to come!
Do the symptoms above describe how your feet feel from time to time? Are you a diabetic? Odds are, you could have what is known as diabetic peripheral neuropathy. What exactly is that, and how did you get it?

Peripheral neuropathy is a condition that most commonly produces symptoms such as burning, numbness, tingling, pain, and loss of muscle function and reflexes in extremities. The areas most commonly affected are the feet and hands. The symptoms can eventually spread "proximally," towards the legs and arms. Causes of peripheral neuropathy besides diabetes include: renal or liver failure, hypothyroidism, excess vitamin B6, deficiency of vitamin B12 or vitamin A, Guillian-Barre Syndrome, systemic lupus erythematosis, leprosy, and shingles, to name a few.

More specifically, diabetic peripheral neuropathy, also called distal symmetric neuropathy or sensorimotor neuropathy, is unfortunately something that as many as sixty to seventy percent of the diabetic population end up experiencing. People with a history of diabetes for over 25 years, or those with uncontrolled blood sugar levels tend to experience the most severe neuropathy symptoms. Once the neuropathy symptoms develop it is very imperative to see your podiatrist on a regular basis for routine and episodic diabetic foot care and risk management.

Your podiatrist will check your feet at a minimum yearly, to assess the skin, muscles, bones, circulation, and sensation of your feet. They will assess the protective sensation in your feet by using an instrument called a Semms-Weinstein 5.07 monafilament wire to determine the extent of your condition. They may also use a tuning fork to assess vibratory sensation.

There are several treatment options for diabetic peripheral neuropathy. First and foremost is to keep blood glucose levels in the normal range, as set by your endocrinologist and podiatrist. Other options include medications both by mouth and topically that is rubbed into the skin. Physical therapy can also help decrease the pain.

It is very important to assess your feet for any type of peripheral neuropathy, especially if you're a diabetic! , The chances of foot injury or infection increases tremendously once sensation to your feet is lost. Oftentimes diabetics cannot even feel something as small as a rock rubbing in their shoes. This can lead to an ulcer (an open wound that does not heal), and possibly progress even to an amputation. The literature indicates that of the 86,000 amputations per year, more than half are in diabetics. This number can drastically be reduced if proper foot care is instituted. Diabetics need to check their feet daily for any rashes, cuts, blisters, scabs, growths, swellings, redness/discolored areas, infections, calluses and for any other suspicious looking areas. Applying the proper lotion to the feet, wearing properly fitting shoes (Medicare does cover diabetic shoes and inserts for qualifying diabetics which look like regular shoes) are also crucial to good foot health. Take good care of your feet, and they will take good care of you for many years to come!


The purpose of this blog is to raise awareness about common conditions associated with the foot and ankle. Any advice given, whether medical or legal, is an opinion. For legal counsel or podiatric care, one should see their local podiatrist or attorney. More information can be found at my website www.michiganfootdoctor.com

Feeling the Blues from Heel Pain?

March Madness is coming underway, basketball fever is beginning to set in, and excitement is in the air! Before you take the court though, make sure that heel pain isn’t going to slow you down! One of the most common conditions that I treat as a podiatrist is something called Plantar Fasciitis. It is by far the number one cause of heel pain.

The plantar fascia is a band of connective tissue along the bottom of the foot. It stretches from the heel to the toes, and its purpose in the body is to support the arch of the foot. The plantar fascia can become strained, inflamed, and swollen. This is what causes the immense pain on the bottom of the foot! Things that contribute to plantar fasciitis include feet that roll in too much (pronation), high arched or flat feet, walking, running or standing for long periods (especially on a hard surfaces such as concrete), obesity and improper shoes. Most people find the most extreme pain to be at its worst when they have been sitting for a long period of time and then walking, or after getting up in the morning and then taking their first few steps. There is actually a word created to describe this exact condition, called "post-static dyskinesia." The theory as to why the pain is the worse at these times is because the fascia tightens up when we sleep and sit for long periods. It has lost the ability to stretch. When we walk small micro tears occur to allow the arch of the foot to flatten out.

This condition is easily diagnosed, because of the specific areas of sharp pain that are usually present. An x-ray will most likely be taken to rule out any trauma or stress fracture or bone tumor of the heel bone (calcaneous). Sometimes on x-ray a heel spur can be seen coming off the bottom of the heel bone. Although the literature says as high as 85% of people with heel pain have a heel bone spur, it is very rare that it is ever surgically removed. This is because of the great deal of research that has been put in to treating this condition conservatively.

Treatment options for plantar fasciitis are focused mainly around rest and stretching! The area is inflamed, so it needs some time to relax! To speed up healing, an anti-inflammatory pill such as ibuprofen (Motrin) or a steroid injection can help. Calf stretching will help release the pull of the calf muscle, which in turn causes the calf muscles not to pull on the fascia as much. Ice and physical therapy can also help with stretching/strengthening exercises, as well as pain relief. Night splints are very helpful as they keep the fascia stretched throughout the night. Orthotics are very important as they accommodate the deformity of the foot and support the arch, preventing the constant stretching of the fascia when we walk. These are used as a long term treatment to prevent any reoccurrence. If all these measures are unsuccessful, do not worry as other options still exist! These include, but are not limited to, minimally invasive endoscopic surgery, Extracorporeal Shockwave Therapy, which uses sound waves to stimulate healing and injection of blood platelet concentrate into the inflamed fascia. Most patients are encouraged to walk after these procedures. Once you start to notice the heel pain, you should try to see your podiatrist before it gets worse! The earlier you treat it, the quicker you can get back in the game, pain free!


The purpose of this blog is to raise awareness about common conditions associated with the foot and ankle. Any advice given, whether medical or legal, is an opinion. For legal counsel or podiatric care, one should see their local podiatrist or attorney. More information can be found at my website www.michiganfootdoctor.com